Catherine Colonnese/Fisher Island Holdings, LLCMi~erai i3~+vft
` ~ ~.,+~
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat
or modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the
City Manager or any rity board or committee; or any action, decision or recommendation of any dty personnel during the rime
period of the entire deri~on-making process on suds action, derision or recommendation that foreseeably will be heard or reviewed
by the dty comml~lon, or a rity board or rnmmittee. The term specincally includes the prinripal as well as any employee engaged
in lobbying activities. The term "lobbyists" has spedfic exdusions. Please refer to Ordinance 2004-3435.
Colonnese Catherine
NAME OF LOBBYIST': (Last) (First) (M.I)
Fisher Island Holdings, LLC, One Fisher Island Drive, Fisher Island, FL 33109
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zp Code)
305-938-2944
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Fisher Island Holdings, LLC,
NAME OF PRINCIPAL/CLIENT:
One Fisher Island Drive, Fisher Island, FL 33109
BUSINESS NAME AND ADDRESS (Number and Street) (Gty) (State) (zrp c;ooe)
(305) 938-2944
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
Fill out tills section If prindpal IS a Corporation, Partnership or Trust [Section 2-482
NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
• FDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Floodplain Management Appeal y ~2
Issue to be lobbied (Describe in detail):
Y.Y~:, r::]I'Ti Kwt;F.WC:IE;S/Y9yp71iXp[hdLsa' 7S3 8k LOBBIED:
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Board of Adjus#ment
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(;ity ~':ommission
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOB'
fLAT RATE OR OTHERS
A) LOBBYIST DISCLOSURE: (Recyilred)-
/`
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
The following information must be answered:
(DISCLOSE WHETHER HOURtf;
v
i) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
^ Yom, ~„No Are you lobbvina on a present or pending bid for goods equipment or services. or on a
,prese:.t or pending award for goods equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
^Yes~ No• Are you lobbvina on a pending application for a Development Agreement with the City or
application for chance of zaninq map designation or chance to the Cttv's Future Land Use
Ma°?
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth in Section 281 above) who only appears as a representative of anot-for-profit
corporation or entity without special compensation or reimbursement for the appearance, whether direct, or
indirect, to express support of or opposition to any item, shall register with the clerk as required by this
section but, shall not be required to pay any registration fees..
Yes ^ No• Are you representing snot-for-profit corporation or entity without special compensation
r Qr reimbursemerrt. .
V, SIGNATURE UNDER OATH:
ON OCTOBER 1~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO E DITURES OR COMPENSA ON DURING THE
REPORTING PERIOD. l~l~ / a . . , . ~ I rai n
Signature of Lob
I do solemnly swear that ali of the foregoing facts are true and correct and that I have read or am
familiar with the provisions rnntained in Section 2-482 of the Miami Beach City Code and all reporting
requirements. /~~`i 1_~ d n . ~. /17~ ,~ n ~ n~ ,,, ,~~ ~
Signature of Lobbyist: l ~,5~'~~'
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
Produced ID _
Form of Identification
~~' Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to nd subscribed before me
This ~ day~sfi-)C l7t,iu ~ ~ , 20 0~'
i f,
Signature of Public Notaryt~ State of Florida
Notarization of Lobbyist's signature
Form of Identification
,~Fersonally known (Princip
" "'•. SODNAI9RINtiAB
~,;~,` ;~ MY COMMISSION A DD 745190
EXPlHES: January 9, 2012
State of Florida, County of Mi aaaed7ruuNaenv~ioundenv~Mera
Sworn and subscribed before me
This (~"~~ da~; of ~r t €;_c~it r~:~ . 2qG '
~__1
Signature of Public Notbry - Sta of Florida
Notarization of Principal's signature
FOR CLERK'S USE ONLY ~ ~
Annual Registration fee: [ j Yes [ ] No Amount Paid ~Q~~~Z MCR # Date Paid
Lobbyist Registration Form received and verified by:
F:~CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc Revised 12J68/Q4
- Produced ID __ __.__
Page 1 of 1
Hatfield, Liliam
From: Gary Snider [gsnider@fisherisland.com]
Sent: Monday, February 11, 2008 12:24 PM
To: Hatfield, Liliam
Subject: Lobbyist Registration Form
Dear Liliam,
Pursuant to our telephone conversation, please accept this email making changes to the Lobbyist
Registration Form of Catherine Colonnese as follows:
Section IV:
A. Lobbyist Disclosure: This function is part of my regular duties with the company.
B. Principal's Disclosure: This function is part of Ms. Colonnese's duties with the company.
Section IV (3):
Fisher Island Holdings, LLC, is n for profit company.
Please contact me should you need anything further in this regard.
Gary Snider
Vice President, Legal Affairs
Fisher Island Holdings, LLC
One Fisher Island Drive
Fisher Island, FL 33109
305.938.2944
02/11/2008